| That is a very good question. | | | | medical clinics. Patients travel from |
| I am not sure any one thing will 'save' | | | | one site, queue up and after being |
| healthcare. We are in a time of 'white | | | | 'processed' in that department are sent |
| water' change in medicine. New | | | | to another department. Thus for a 2 |
| discoveries and new treatments race to | | | | minute blood test, 5 minute radiograph |
| the bedside. There will instead be a | | | | of the chest and a 10 minute doctor's |
| constellation of things that will | | | | visit the patient may have spent all day |
| improve our healthcare systems. The | | | | go to and from these functional |
| future of medicine is in the provision | | | | villages. The clinics of the near future |
| of personalized medicine. This is | | | | should be organized into a "cellular" |
| typically discussed in relationship to | | | | model which will allow all the services |
| the Humane Genome project and molecular | | | | to take place within the clinic, rather |
| medicine. However, it is much more than | | | | than this functional "village' model |
| that. | | | | where patients travel between functions |
| Personalized medicine is providing the | | | | such as lab, clinic and radiology. In |
| 'right care at the right time'. Often in | | | | the future those functions will be |
| the management of chronic conditions | | | | provided at the point of care. |
| care is arranged 'just in case'. | | | | Personalized medicine will become the |
| Appointments are scheduled into the | | | | 'right care, at the right time, in the |
| future 'just in case' you need to be | | | | right place'. |
| seen. This is a symptom of the tradition | | | | Lean Thinking in healthcare is not just |
| of medicine that dictated care to the | | | | about how to reduce the administrative |
| patient rather than negotiated care with | | | | burden or waiting times of the patient. |
| the patient. Personalized medicine will | | | | It is also important to consider the |
| change our healthcare processes | | | | costs that patients undergo in accessing |
| dramatically in the future. Personalized | | | | services. Even if the patient does not |
| medicine will require our systems to | | | | pay personally for their care, there is |
| provide 'customized' solutions for | | | | a cost. Much of that cost is hidden and |
| patients. Medications are chosen based | | | | does not occur in the clinic or |
| on a genetic analysis of the patient. | | | | hospital. It occurs as a result of the |
| Other patient needs will also become | | | | time and effort to get to the hospital |
| important to meet. After hours clinics | | | | or clinic. An easy illustration is |
| already seek to personalize care. | | | | trouble a patient undergoes in traveling |
| Patients will be able to request or pull | | | | to the office, finding a parking place, |
| services without long queues. Some | | | | then walking to the office and then |
| systems already allow patients to go | | | | repeating at the other 'villages'. The |
| online and select their appointment time | | | | travel costs represent a barrier to many |
| without ever speaking to a clerk. The | | | | of our patients. Technology solutions |
| services they pull will be those that | | | | will allow an amendment to the mantra of |
| have value for them. Lean will provide | | | | 'right care at the right time' by |
| the basis for understanding the value | | | | providing care at a distance. |
| added activities that will compose | | | | Telemedicine and telehealth combined |
| personalized medicine. | | | | with point of care testing will be a |
| Lean Thinking is directed at reducing | | | | norm. This will move medicine away from |
| waste. This will allow a greater | | | | the bricks and mortar of the clinic and |
| productivity for those value added | | | | hospital. The mantra will become 'the |
| services. For this reason management | | | | right care, at the right time, in the |
| science will be as important as basic | | | | right place, using the right |
| sciences in the healthcare of the | | | | technology.' |
| future. So called 'implementation | | | | Lean thinking actually challenges |
| science' or 'translational science' is | | | | healthcare administrators to develop |
| little more than systematically applying | | | | systems that provide 'the right care, at |
| management theory in the delivery of | | | | the right time, in the right place using |
| evidenced based practices. Currently it | | | | the right technology.' By applying Lean |
| has been estimated that approximately | | | | Thinking as new services and buildings |
| 50% of a clinician's time is not | | | | are considered all of this is possible |
| necessary and not value added in the | | | | today. The future is here. But it will |
| eyes of the patient. If this waste is | | | | take administrators and physician |
| eliminated then clinician's will be able | | | | executives prepared to think lean to |
| to spend more of their time caring for | | | | fully capitalize on the changes. So you |
| patients. This will reduce frustration | | | | could say that Lean Thinking will be as |
| for both clinician and patient. | | | | important to 'saving' healthcare as any |
| Currently most facilities are organized | | | | advance in the biological sciences might |
| around functional department such as | | | | be. |
| laboratory testing, radiology, and | | | | |